Abstract
A 5-year-old male with a ventricular septal defect associated with Down's syndrome, who had a previous history of pulmonary artery banding, underwent intracardiac repair. Severe hypoxemia occurred during the weaning from cardiopulmonary bypass. In postoperative evaluations, a severe intrapulmonary shunt was detected. There was no residual pulmonary stenosis or cardiac failure. Extracorporeal membrane oxygenation and intravenous gamma globulin infusion were attempted for a period of 5 days for the treatment of the hypoxemia. These therapies were not effective and the patient died 10 days after surgery from mediastinitis which occurred on postoperative day 7. Respiratory syncytial virus antibody was detected and lung specimens, which were resected on postoperative day 3, revealed an emphysematous distension of alveolar air space without pulmonary hypertension or pulmonary artery hypoplasia histologically. Respiratory syncytial virus infection in children may be an additional risk in cardiovascular surgery.
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